Intensive Care Unit Nurses' Experiences in Caring for Lightly Sedated Mechanically Ventilated Patients: An Extended Literature Review

Abstract

Background: Sedation is crucial for critical care patients' comfort and treatment. The trend has moved towards lighter sedation levels than deep sedation. Lightly sedated intubated patients require more focused care in a suitable setting compared to deeply sedated patients. Intensive care unit (ICU) nurses, as carers, hold a pivotal position in care and sedation monitoring. There remains a lack of comprehensive investigation into nurses' psychological and professional experiences during the care management process.

Aim: To explore ICU nurses’ experiences of caring for intubated patients under light sedation.

Methodology: This dissertation employed the Extended Literature Review (ELR) method by using six electronic databases were systematically searched: the Cumulative Index for Nursing and Allied Health Professionals (CINAHL) Plus, Medline, PsycINFO, Scopus, and Web of Science. English-language studies were included and conducted between 2013 and 2023, examining nurses' caring experiences while managing light sedation with mechanically ventilated patients. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) and the Mixed Methods Appraisal Tool (MMAT) checklists.

Results: Eight studies met the inclusion criteria: five qualitative, two mixed methods, and one cross-sectional study. Qualitative studies revealed that ICU nurses face significant challenges in achieving and maintaining light sedation while ensuring patient comfort. Mixed methods studies indicated that nurses were generally satisfied with patient outcomes associated with light sedation approaches. The cross-sectional study demonstrated a high level of compliance among nurses with light sedation guidelines and its implications for intubated patients. Four overarching themes emerged from the analysis, providing insights into ICU nurses' experiences during the care provided for ventilated patients under light sedation.